Motivational Services : Mental Health Care : Vocational Rehabilitation : Community Support : Employment and Housing Support

The Training Center
A Division of Motivational Services, Inc.

Registration Form

If you are interested in registering for an class at The Training Center complete the form below and submit it to us. Please note that in order for us to receive your registration properly, you will need to be running an e-mail application such as Outlook, Outlook Express, or any other e-mail application on your computer. Persons using Internet based e-mail accounts such as Hotmail and Yahoo should print the application and mail it to Motivational Services.

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Your Name:
Course Name:
Course Date(s):
Cost:
Accomodations:
Agency Name:
Contact/Training Coordinator:
Mailing Address:
City:
State:
Zip Code:
Phone:
Fax Number:
Email Address:

Important Information

Payment is due prior to class. Please make checks payable to: Motivational Services, Inc. and send payments/correspondence to the address below. To arrange a billing relationship for your organization please contact Chele Dacus at the Training Center-(207)623-7721.

A two(2) business day notice is required for refunds.

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For more information contact:
Chele Dacus, Training Manager
The Training Center
Mailing Address: PO Box 229
Physical Location: 71 Hospital St.
Augusta, Maine 04332-0229
Phone: 207-623-7721
Fax: 207-623-3130
Email
http://www.mocomaine.com

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